Surrogates for Identifying Pre-School Children with Iron Deficiency Anaemia: Is Red cell indices useful?

Abstract

There are difficulties in determining children with iron deficiency anaemia in developing countries due to cost of serum ferritin estimation. We sought to determine the relationship between red cell indices and serum ferritin among pre-school children. A random sample of 89 apparently healthy children was recruited. Serum ferritin was measured by ELIZA while red cell indices were determined by auto-analysis.Correlations analysis was performed to test the relationship between serum ferritin and the red cell indices. Also validity testing of red cell indices as screening tools was performed using the sensitivity, specificity, and predictive values. Weak significant positive correlations were seen between serum ferritin and MCV, and MCH irrespective of the anaemic status of study subjects anaemia status (p = 0.020, and 0.040 respectively). Following stratification according to presence or absence of anaemia, a significant positive correlation was seen between serum ferritin and MCV among subjects with anaemia. None of the red cell indices were found to reach significant correlation levels with the red cell indices in non-anaemic study subjects. There were notable difference between sensitivity, specificity, and predictive values using MCV compared with MCH in the anaemic children.  MCV was observed to be a useful surrogate for predicting iron deficiency state in pre-school children with anaemia where serum ferritin is not readily available.

Keywords: Children, Surrogate, Iron deficiency anaemia, Red cell indices